√ 16 Efek samping Obat KORTIKOSTEROID, Penggunaan dan 10 Contoh Obat KORTIKOSTEROID

Efek samping, penggunaan dan contoh obat kortikosteroid– obat golongan kortikosteroid bekerja dengan mempengaruhi hormon kortikosteroid di dalam tubuh. Banyaknya jenis obat yang bekerja mempengaruhi hormon kortikosteroid membuat orang bingung untuk membeli obat kortikosteroid yang bagus di apotik.  Obat kortikosteroid sebagian besar adalah obat yang harus dibeli dengan resep dokter karena termasuk golongan obat keras, tetapi ada juga yang tidak harus dengan menggunakan resep dokter. Obat kortikostreoid yang paling laris dijual di apotik salah satunya yaitu Dexsamethasone. Hampir di seluruh apotik mempunyai stok obat deksamethasone karena memang obat kortikostreoid ini biasanya diresepkan oleh dokter sebagai terapi pengobatan tambahan. Nah sebelum mengulas mengenai apa saja contoh obat kortikostreoid di apotikserta penggunaan dan efek samping obat kortikosteroid silahkan simak apa itu kortikosteroid terlebih dahulu.
obat kortikosteroid
obat kortikosteroid
Kelenjar adrenal terletak berdampingan dengan ginjal terdiri dari bagian kulit (kortek) dan bagian sumsum (medula). Kortikotropin atau ACTH merangsang kelenjar anak ginjal (adrenal) menyekresikan hormon – hormon. Kelenjar adrenal bagian kortek atau kulit menyekresikan hormon kortikosteroid dan hormon kelamin, sedang bagian sumsum (medula) menyekresikan adrenalin dan noradrenalin.
Kortikosteroid memiliki 2 aktivitas ,yaitu :
A. Glukokortikoid
– Mempengaruhi metabolisme karbohidrat dan protein serta sedikit mempengaruhi keseimbangan air dan elektrolit
– Mempunyai efek antiinflamasi dan imunosupresif
– Glukokortikoid alam adalah kortisol dan kortison. Sedangkan glukokortikoid sintetik adalah prednison dan betametason.
B. Mineralokortikoid
– Mempengaruhi keseimbangan elektrolit dan air. Mineralokortikoid alam adalah aldosterone.
– Mekanisme kerja seperti hormon steroid lain, adrenokortikoid mengikat reseptor sitoplasmik intraseluler pada jaringan target. Ikatan komplek antara kortikosteroid dengan reseptor protein akan masuk ke dalam inti sel dan diikat oleh kromatin. Ikatan reseptor protein-kortikosteroid-kromatin mengadakan transkripsi DNA, membentuk mRNA dan mRNA merangsang sintesis protein spesifik.
a. Glukokortikoid
1. Merangsang glikogenolisis (katalisa glikogen menjadi glukosa) dan glikoneogenolisis (katalisa lemak/ protein menjadi glukosa) sehingga kadar gula darah meningkat dan pembentukan glikogen di dalam hari dan jaringan menurun. Kadar kortikosteroid yang meningkat akan menyebabkan gangguan distribusi lemak, sebagian lemak di bagian tubuh berkurang dan sebagian akan menumpuk pada bagian muka (moonface), tengkuk (buffalo hump), perut dan lengan.
2. Meningkatkan resistensi terhadap stress. Dengan meningkatnya kadar glukosa plasma, glukokortikoid memberikan energi yang diperlukan tubuh untuk melawan stress yang disebabkan oleh trauma, ketakutan, infeksi, perdarahan atau infeksi yang melemahkan.
3. Merubah kadar sel darah dalam plasma. Glukokortikoid menyebabkan menurunnya komponen sel-sel darah putih/ leukosit (eosinofil, basofil, monosit dan limfosit), sehingga memungkinkan munculnya infeksi seperti TBC. Sebaliknya glukokortikoid meningkatkan kadar hemoglobin, trombosit dan eritrosit.
4. Efek anti inflamasi. Glukokortikoid dapat mengurangi respons peradangan secara drastis dan dapat menekan sistem imunitas (kekebalan).
5. Mempengaruhi komponen lain dari sistem endokrin. Misalnya penghambatan umpan balik produksi kortikotropin oleh peningkatan glukokortikoid menyebabkan penghambatan sintesis glukokortikoid lebih lanjut.
6. Efek anti alergi. Glukokortikoid dapat mencegah pelepasan histamin.
7. Efek pada pertumbuhan. Glukokortikoid yang diberikan jangka lama dapat menghambat proses pertumbuhan karena menghambat sintesis protein, meningkatkan katabolisme protein dan menghambat sekresi hormon pertumbuhan.
8. Efek pada sistem lain. Hal ini sangat berkaitan dengan efek samping hormon. Dosis tinggi glukokortikoid merangsang asam lambung dan produksi pepsin sehingga menyebabkan kambuhnya (eksaserbasi) borok lambung (ulkus). Juga telah ditemui efek pada SSP yang mempengaruhi status mental. Terapi glukokortikoid kronik dapat menyebabkan kehilangan massa tulang yang berat (osteoporosis). Juga menimbulkan gangguan otot (miopati) dengan gejala keluhan lemah otot.
b. Mineralokortikoid
Efek mineralokortikoid mengatur metabolisme mineral dan air. Mineralokotikoid membantu kontrol volume cairan tubuh dan konsentrasi elektrolit (terutama Na dan K), dengan jalan meningkatkan reabsorbsi natrium, meningkatkan ekskresi kalium, dan air. Efek ini diatur oleh aldosteron (pada kelenjar adrenal) yang bekerja pada tubulus ginjal, menyebabkan reabsorbsi natrium, bikarbonat dan air. Sebaliknya, aldosteron menurunkan reabsorbsi kalium, yang kemudian hilang melalui urine. Peningkatan kadar aldosteron karena pemberian dosis tinggi mineralokortikoid dapat menyebabkan alkalosis (pH darah alkali) dan hipokalemia, sedangkan retensi natrium dan air menyebabkan peningkatan volume darah dan tekanan darah.
Penggunaan Obat Kortikosteroid
a. Terapi pengganti pada penderita gagal adrenal (misalnya penyakit Addison). Semua efek glukokortikoid diperlukan dan sediaan mineralokortikoid perlu diberikan bersama glukokortikoid.
b. Terapi antiinflamasi dan immunosupresif
c. Asma (secara inhalasi atau pada kasus berat secara sistemik)
d. Secara topikal pada peradangan mata , kulit, telinga atau hidung (misalnya eksim, konjungtivitis alergi atau rhinitis alergi)
f. Hipersensitivitas (misalnya alergi berat terhadap obat atau bisa saja terhadap serangga)
g. Penyakit autoimun dan inflamasi
h. Penyakit neoplastik
i. Kombinasi dengan obat sitotoksik pada pengobatan keganasan spesifik, misalnya leukimia
j. Mengurangi edema serebral pada penderita tumor otak (digunakan deksametason)
k. Antiemetik pada pengobatan kemoterapi
Efek Samping dan Kontraindikasi Obat Kortikosteroid
Efek samping terjadi umumnya pada terapi dosis tinggi atau penggunaan jangka panjang kortikosteroid. Adapun efek samping dan komplikasi yang dapat terjadi antara lain :
1. Tekanan terhadap respon infeksi
2. Infeksi menjadi luka serius kecuali diberikan bersama antimikroba
3. Penyembuhan luka terganggu
4. Menyebabkan ulkus peptikus
5. Metabolisme glukosa, protein dan lemak; atropi otot, osteoporosis dan penipisan kulit
6. Elektrolit; Hipokalemia, alkalosis dan gangguan jantung hingga terjadi gagal jantung (cardiac failure)
7. Kardiovaskuler; aterosklerosis dan gagal jantung
8. Tulang ; osteoporosis dan patah tulang spontan
9. Otot ; kelamahan otot dan atropi otot
10. SSP dan psikis ; gangguan emosi, euforia, halusinasi hingga psikosis
11. Elemen pembuluh darah ; gangguan koagulasi dan menurunkan daya kekebalan tubuh (immunosupresi)
12. Pertumbuhan ; mengganggu pertumbuhan anak, kemunduran dan menghambat perkembangan otak
13. Ginjal ; nokturia (ngompol), hiperkalsiuria yaitu peningkatan kadar ureum darah hingga gagal ginjal
14. Pencernaan ; tukak lambung (ulkus peptikum)
15. Pankreas ; peradangan pankreas akut (pankreatitis akut)
16. Gigi ; gangguan email dan pertumbuhan gigi
A. Glukokortikoid kerja singkat (8 – 12 jam) :
1. Hidrokortison           : Cortef
2. Kortison                   : Cortone
B. Glukokortikoid kerja sedang (18 – 36 jam) :
3. Prednison                : Prednisol, Delta-Cortef
4. Prednisolon             : Prelone, Medrol
5. Metilprednisolon      : Medixon, Kenacort
6. Triamsinolon           : Triamcort
C. Glukokortikoid kerja lama (1 – 3 hari) :
7. Betametason           : celestone, Oradexon
8. Deksametason        : Dexa-M
D. Mineralokortikoid :
9. Fludrokortison         : Florinef
10. Desoksikortikosteron : Astonin
Demikianlah tadi penjelasan lengkap tentang apa itu kortikosteroid, pengguanaan kortikosteroid, efek samping dan contoh obat kortikosteroid di apotik yang sudah admin inFarmasi ulas pada kesempatan kali ini. Semoga ulasan tentang obat kortikosteroid dan penggunaan obat kortikosteroid diatas dapat bermanfaat dan menambah wawasan anda tentang dunia kefarmasian. Jika ada pertanyaan silahkan tinggalkan di kolom komentar di bawah ini.

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